Pandemic accelerates next-generation design in senior living
Wednesday, July 22, 2020
With among the highest mortality rates in the nation, nursing homes and assisted living facilities are applying a battery of solutions to contain the spread of the COVID-19 virus and provide greater protection against contagion for residents and staff.
Because it spreads so rapidly, often undetected, and is disproportionately fatal in the case of elderly patients, the pandemic has exposed underlying vulnerabilities in the current design and operation of senior living facilities. This has some in the sector, including architects and designers, developing new models of what senior living might look like in the near future.
Although only 9% of all coronavirus cases in the United States since the onset of the pandemic in March have occurred in nursing homes, they account for 42% of all deaths (57,000 residents and workers, as of July 15), according to data collected by The New York Times. A federal investigation of conditions in assisted living facilities conducted in late April and May found that nearly 1 in 4 had at least one positive test for coronavirus among residents, and of those testing positive around 43% were hospitalized and nearly one third died.
Residents in long-term care facilities have experienced higher rates of infection and death than those in other types of senior living communities. On the whole, they tend to be older and have multiple health issues.
A study involving a sampling of different types of senior care facilities conducted by the National Investment Center for Seniors Housing & Care (NIC) found that nursing homes and memory care facilities had higher proportions of residents testing positive, with assisted living and independent living facilities experiencing much lower rates.
To various extents, facilities have employed a wide variety of strategies to try to reduce infections and fatalities. They have increased testing, quarantined those who test positive for the virus, implemented more rigorous cleaning and disinfecting protocols, purchased protective gear for staff, eliminated group dining and other activities, and prohibited visitors. In addition, over time knowledge about the virus and how to treat it have improved, helping to decrease fatalities.
One factor contributing to the health crisis in senior living facilities is the design of the facilities themselves. They were not created to deal with such a widespread outbreak. In an effort to provide guidance to administrators, healthcare professionals, and state officials on how to improve conditions in facilities, the American Institute of Architects (AIA) issued “Strategies for Safer Senior Living Communities” in May. It identifies environmental risks related to COVID-19 transmissions and describes design and behavioral strategies to minimize or eradicate those risks.
Others in the sector are looking ahead to what the next generation of senior living might look like. Speaking with Multi-Housing News, Daun St. Armand, senior vice president at CalisonRTKL, discussed a number of factors that architects and designers will need to consider in designing or renovating facilities in the future.
He emphasized the need for greater flexibility and adaptability in design so administrators can respond more quickly to changing conditions, repurposing and isolating spaces as needed. He also spoke of ways to increase the use of technology and reconfigure resident quarters to allow for continued socialization and visits during a health emergency.
Going a step further, OZ Architecture of Denver released a white paper, “Designing for Emergency Preparedness: Considerations to Reduce the Spread of Disease and Infection in Older Adult Communities During an Emergency,” that, along with recommendations for immediate steps administrators and facilities personnel can take to make their properties safer, makes the case for moving to a small house model for older communities — an idea that had been gaining traction prior to the pandemic. The paper illustrates various ways the model lends itself to compartmentalizing public, private, visitor and delivery spaces, and how it can be applied to meet a range of needs, scales and footprints.
For some time now, the senior living sector has been facing declining occupancies as more older persons choose to remain in their own home or to live with family members or friends. News reports of high fatalities in nursing homes likely will heighten their reluctance to opt for a communal living environment. Innovative designs, like the small house model, could help to turn around that trend. In an odd way, the pandemic may be pushing senior living even faster toward the future it needs to embrace.
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